Microsurgery is a general term used to refer to surgery that requires magnification with an operating microscope, on structures that are very delicate or small, such that microsurgical techniques result in better visualization, better precision, and hence better outcome. Under magnification of up to 40 times, and using very fine instruments, and sutures that are finer than the human hair, nerves and blood vessels with sizes as small as 1mm or less can be repaired.
Microsurgical procedures in hand and orthopaedic surgery are now commonly done. Currently, microsurgery is commonly used in Singapore to reattach amputated fingers and limbs, transfer tissues from different parts of the body including the toe to the hand, in eye surgery, ear surgery, urology, neurosurgery and plastic surgery. Microsurgical techniques have enabled surgeons to do much more than was previously possible, and opened up many possibilities. The benefits of microsurgery have led to its popularity particular in Singapore.
Commonly Performed Microsurgery Procedures at BJIOS Orthopaedics
- Nerve repairs
- Repair of arteries and veins
- Surgery for crush and other traumatic injuries
- Reattachment of fingers, hands and arms, toes and legs
- Toe to thumb/hand transplant
- Skin and muscle transfer to cover complex wounds
- Vascularised bone transfer to bridge large bone gaps
Preparing for Microsurgery
As microsurgery is a complex procedure, with many factors affecting the outcome, proper assessment of the patient is required before surgery. Conditions that affect the blood vessels and circulation, such as diabetes and smoking, as well as the degree of damage of the tissues, need to be properly assessed. Blood tests, x-rays, angiogram (imaging to assess the patency of the blood vessels) and other specialized tests may need to be done.
Patients with serious medical conditions may not be suitable to under complex microsurgical reconstruction surgery.
After a successful surgery the patient is usually given an intravenous fluid before being given a regular food. The surgeon will ensure that the patient is kept warm and well hydrated to improve circulation to the microsurgery site, and to enhance the recovery process. The surgical site will be elevated to help reduce swelling. Over the counter medication will be administered to help the healing process as well as manage the pain. The patient will only be discharge from the hospital if the surgeon is sure that he/she is stable and is responding well to medication given.
After the patient is discharged, the doctor closely monitors the patient’s progress until when the patient has fully recovered. Specially guided rehabilitation is important after microsurgery reconstruction. Such rehabilitation programs can help restore function to a transplanted or replanted body part.